Archives for June 2017

Proctalgia fugax is described as a condition that leads to rectal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing.

recur over weeks, is localized to the anus or lower rectum, and can last from seconds to several minutes with no pain between episodes. There is no diurnal variation. There are numerous precipitants [preceding factors] including sexual activity, stress, constipation, defecation and menstruation, although the condition can occur without a trigger.

Although the cause of proctalgia fugax is unclear, spasm of the anal sphincter is commonly implicated. The condition may be more likely to occur after sclerotherapy for hemorrhoids and vaginal hysterectomy. There are also associations with other functional pathologies, such as irritable bowel syndrome and anxiety.

My story

I have experienced this awful anal sphincter spasm and pain myself so I want to shine some light on this condition and offer the simplest and most effective solution: oral and sublingual GABA. It works to completely eliminate the pain in 1-2 minutes! And it can also be used to prevent a full-on spasm if you catch it in advance. More about this below.

Let me first share my story so you can relate to the pain. I started to experience this a few years ago. It was right after my aunt died from rectal cancer and my immediate thought was that I was dying of cancer. That’s how bad the pain was. It’s like nothing I’ve ever experienced and I’ve had some pretty bad pain experiences: shingles, a tick bite headache, ice-pick headaches from a neck injury and poking my eye on a tree-branch while hiking.

For me, since it initially used to happen during the night, it felt like I was in bad dream and was lying somewhere injured and in agony. I would half wake-up moaning in pain, not quite grasping how the pain I was feeling could be so bad. Then I would come fully awake and feel the need to bear down (as in needing to have a bowel movement) but this would actually make it worse.

How do others describe the pain?

When I shared this paper on facebook one woman said her rectal pain and spasms last 20-30 minutes and is bad a childbirth.

Someone else shared that her husband “complained of feeling like a knitting needle was being driven through his anus.”

What do I think my triggers are?

I have not had sclerotherapy for hemorrhoids or a vaginal hysterectomy. I do have a history of anxiety and panic attacks (in my late 30s) and do have IBS/SIBO right now and I suspect that both low GABA and IBS/SIBO are my biggest root causes. I no longer have any anxiety but since I respond so well to GABA I assume my GABA levels are not optimal (likely due to the SIBO). I suspect exposure to hidden sources of gluten could also be a factor, and this could also affect my GABA levels.

Medications or heating pads as a solution?

A warm bath has been reported to help but I was looking for a 1-2 minute fix (and less if possible). Once you’ve experienced this pain you’ll understand that you not imagine running a bath in the midst of a spasm and waiting to get in it.

Heating pads do also work but can take 20 minutes to take effect and that is simply too long for most people.

The first solution for in-the-moment relief (takes 2 to 12 minutes)

After the first episode I started searching online and because I didn’t know it was called proctalgia fugax I searched for “rectal cramp”, “rectal spasm”, “anal cramp” and came across forums with hundreds of women asking about it and describing their pain.

But no-one really had a solution and many had seen their doctors without much success. The best solution that many people use is 30-60 seconds of finger pressure (with the finger wrapped in toilet paper) in the anal sphincter during a spasm. Sometimes this is needed for up to 2-3 mins and sometimes doing this 2 or 3 times a few minutes apart is needed. Think about how you put pressure on a calf muscle spasm to stop the cramps. This works well but the agony can last for the entire 2 to 12 minutes (depending on how many times it has to be done). Adding a small amount of arnica cream onto the toilet paper seems to helps too.

How common is it?

It took more searching and reading and then I discovered what it was called. Once I found a name for it and started looking into I was surprised to see how common it is:

The prevalence of proctalgia fugax in the general population may be as high as 8%–18%. Many patients present to primary health care physicians and often do not require further consultation because the symptoms are fleeting. This condition is more common among women than among men, and usually affects patients between 30 and 60 years of age.

Although it’s more common among women I worked with a male client who experienced this. During one of his episodes, the pain was SO bad he actually passed out and hit his head on the bathroom floor.

The best solution for almost-immediate relief (takes 1 minute)

I know that GABA works amazing well for physical anxiety and stiff and tense muscles and I decided to try GABA in the midst of a spasm. It worked amazingly well and within 1 minute the terrible pain started to ease. It does need to be taken sublingually and I have found that 250mg to 500mg opened onto my tongue works best for me.

Each person would need to find the ideal amount for their needs but at night this should be a reasonable amount. During the day this could be too much and make you sleepy or too relaxed.

I’ve also used a combination of sublingual GABA and theanine with similar results.

I know GABA isn’t readily available everywhere so I did an experiment with taurine and found I needed more (at least 1000 mg) and it did take longer (2-3 minutes) to get relief, but it did work.

THE immediate solution for preventing the spasm

But I have now gotten to the point where I can nip it in the bud and prevent the spasm altogether – by taking sublingual GABA at the very first hint of an ache or twinge. I’ve been fortunate that when this does happen (about once a month and sometimes every 2 months) it’s around 8-11pm.

The long-term solutions for getting to the root cause/s?

We always want to get to the root cause of an issue and that is the next step. I reached out to the practitioners in my community to ask them how they help their clients and patients with this and what approaches they have used to end the spasm and pain. I will be sharing some of their solutions and how to get to some of the root causes in part 2.

I’d love your feedback!

I’d love your feedback so I can learn what works, so we can all learn from each other and so others get answers quicker than I did.

Have you ever experienced this rectal pain and spasms? And what has worked for you?

I’d love to know if it is more common after sclerotherapy for hemorrhoids and vaginal hysterectomy? Have you had either? Or any surgery in the abdominal area?

Do you also have IBS/SIBO? What about celiac disease or gluten sensitivity?

Do you currently have anxiety or mood issues or have a history of anxiety or mood issues? How many low GABA and low serotonin symptoms do you have – here is the questionnaire (a paper from 1965 mentions that patients with proctalgia fugax have been described as irritable, perfectionistic, meticulous, obsessional, tense, and anxious)

If you’ve tried GABA or these other approaches (or decide to try them) please come back and share. Too many people don’t know about this and it needs to change!

TouchPoints™ basic are non-invasive neuroscientific lifestyle wearables that use patent pending neuroscience to relieve stress, improve sleep, performance, and focus, and can reduce cravings and anger.

I shared some information about these TouchPoints™ neuroscience devices a short time ago and it created some interest. This week I was just on a private call with one of the founders, Dr. Amy Serin and I’m so impressed with what I learned about these EMDR-type devices that I’m sharing their indiegogo campaign (happening right now) for the new lower price point device (the basic). The Basic device doesn’t use an iphone or ipad. I am somewhat concerned about EMFs with their other device and I’m still looking into this to determine if it is an issue.

This Basic device can be worn on a wrist-band or can be worn on a belt, socks, shirt etc.

I have NOT yet used one of these devices myself or with clients but I have purchased one to test and will share more as I learn more. Please do share your experiences too!

As with addressing any imbalance too much of something can be problematic. I received this feedback from a colleague who is a psychotherapist:

We use bilateral stimulation in our work with various gadgets – bilateral music with headphones, bilateral tappers etc. It’s been used with EMDR for 20 years. I haven’t seen this gadget before but the idea is not new. It can also be TOO activating and increase sympathetic arousal for some people.

If they work you I do see these as a great add-on to the nutrition work I do for anxiety (diet, adrenals, amino acids like GABA etc.) and could be especially helpful if you can’t tolerate supplements right now (like during a benzodiazepine taper or being highly sensitive).

The goal of a 2015 Russian study titled Gluten Migraine, was to study the prevalence of migraine among patients with celiac disease and to assess the efficacy of a gluten-free diet in its treatment. There were 200 celiac disease (CD) patients and the

CD group had migraine syndrome four times more often than the control group. The attacks were more frequent in CD patients who were older than 50 years old.

The migraines disappeared in 25% of patients with migraines who were on the gluten free diet and the reduction in the intensity and/or frequency of attacks was observed in 38% of patients.

This is the study conclusion:

We revealed the clear association between migraine syndrome and CD and the high efficacy of gluten FREE diet in the treatment of migraine symptoms.”

I would suspect similar results if you have gluten sensitivity. And here is some gluten-migraine feedback from 4 different women in my community:

HUGE decrease in my migraines now that I eat more cleanly. I used to start to get headaches immediately upon eating gluten-y meals

I had them frequently from teenage years right up until my Celiac diagnosis in my thirties. Once gluten was gone so were the migraines

Stopping gluten stopped my migraines

My migraines always came from gluten and dairy

Of course there is also an anxiety-gluten and the depression-gluten connection so getting the gluten out of your diet will help with both anxiety and depression most of the time too.

The other topic I cover is the autoimmune condition called Antiphospholipid Syndrome (APS) which is one of many possible contributing factors for both migraines and anxiety. Of course, with any autoimmune condition gluten removal is key.

I also cover low serotonin as one possible cause of migraines (and anxiety) and the use of tryptophan (instead of SSRIs). An amino acid like tryptophan or GABA also helps you break the gluten addiction so you don’t have to rely only on willpower!

The Chronic Headache & Migraine Summit will be online from July 10-17, 2017

Hosts of The Chronic Headache & Migraine Summit, Erin Knight, Corey Schuler and Marta Taylor, are familiar with headache pain and migraines; they’ve all experienced severe headache problems. They found functional medicine solutions, which they now share in their health practices each day. Discover in one week what they’ve spent years learning!

SIBO (Small Intestine Bacterial Overgrowth) is the #1 leading cause of IBS and other digestive problems and can cause bloating, chronic constipation or diarrhea (or both!!), anxiety, depression, pain and a host of other symptoms.

Shivan Sarna and co-host Dr. Allison Siebecker (a SIBO expert and hero of mine), are bringing some of the foremost experts in the country together to discuss this potentially life altering disease. Over 5 full days of expert interviews Shivan will take a deep dive into the causes, treatment options and expert opinions on everything from diet, to medication you need to know about to regain your optimal health and how to beat SIBO (even if you didn’t know you had it!)

You’ll also meet a host of patients who have lived with SIBO and have learned how to heal themselves… their passionate stories will give you the hope you need.

In her SIBO treatment interview Dr. Siebecker shares the following:

There’s several layers that we can aim our treatments at. I would say the top layer is the symptoms. And of course we want to get somebody feeling symptomatically better as soon as we can. And this is in regards to SIBO, it could apply to other diseases but specifically SIBO. The next layer down would be the bacteria. That’s the actual SIBO, the accumulation of bacteria in the small intestine aiming at eliminating those bacteria. And then the bottom layer would be the underlying cause of the SIBO. And that’s really where most of us probably want to focus our treatment because if we can get rid of the underlying cause well then we can get rid of SIBO and we can cure it, but that isn’t so easy.

I love these 2 tips she shares for the painful bloating:

something that helps a lot is charcoal, activated charcoal because it actually absorbs… gas into its little pockets and chambers inside the charcoal. That can really help people, especially if you’re having pain from the bloating that can really help.

Another thing is you can lie face down on your stomach and it puts the anatomy in a position where it can allow gas to be burped out and you can get some relief that way.

I’ve used the latter face down position but didn’t know about the charcoal tip, which is why I love these summits – I always learn something new!

Dr. Siebecker goes on to share in detail about

pharmaceutical antibiotics

herbal antibiotics (you would need to add in the allicin/Alimed if you had constipation type of SIBO or high methane)

prokinetics like triphala, MotilPro and Iberogast (and some pharmaceutical prokinetics) to assist motility

the elemental diet

visceral manipulation, massage and acupuncture

She ends with how important stress reduction is and that’s where my work comes in!

It’s an excellent read for creating awareness about anxiety and benzodiazepines but also sad because there is so much we can do and no solutions are offered. Here are some startling stats shared in the article:

According to data from the National Institute of Mental Health, some 38 percent of girls ages 13 through 17, and 26 percent of boys, have an anxiety disorder. [Note: this was quoted in the article. I’m trying to track down the source because an article in Time Magazine last year says this: ‘About 30% of girls and 20% of boys–totaling 6.3 million teens–have had an anxiety disorder, according to data from the National Institute of Mental Health’ as of 2015.]

On college campuses, anxiety is running well ahead of depression as the most common mental health concern, according to a 2016 national study of more than 150,000 students by the Center for Collegiate Mental Health at Pennsylvania State University. [Both anxiety and depression have shown slight but persistent increases each year for the past six years]

Meanwhile, the number of web searches involving the term [anxiety] has nearly doubled over the last five years, according to Google Trends. (The trendline for “depression” was relatively flat.)

I’m the optimistic type, I’m proactive and I like to give hope as well as solutions – and I have quite a bit to say about this article so here goes.

#1 Too many people are prescribed benzodiazepines without knowing what they are getting into

The article does not address the issues with benzodiazepines: how too many people are prescribed benzodiazepines without knowing what they are getting into, with many suffering dreadfully and never offered nutritional solutions. When I shared the article on my facebook page, someone in my community shared this (and gave me permission to share it further in the hope someone else will be spared her suffering)

Been totally disabled by benzo for 3.5 years. I have been off meds for 17.5 months and the impact of these meds makes any anxiety I ever felt a cake walk. Please run from the poison. Find healthy foods, nutrition and take the break your body is begging you for. We need to listen to our bodies! If it is screaming with anxiety maybe you need to make some life changes. I wish I did instead of taking a med that has almost destroyed me.

I asked her what symptoms she was experiencing, and as well as suffering from severe motion sickness (so badly she can’t even leave her home) she also shared this:

I have locked shoulder muscles, neck, jaw; I have internal vibrations, I get bad headaches, jelly legs, distorted vision like floaters and squiggles and fireworks, my teeth all feel like they will fall out but they are not lose, it feels like adrenaline or cortisol rushes through the body. Sometimes arms go numb. I am pretty tortured every day. These meds are truly causing chemical warfare on some of us.

I believe this will be the next big epidemic and I hope I heal somehow to help others

#2 Let’s help anxious individuals like you find solutions

The silver lining for those with nervous disorders is that we can welcome our previously non-neurotic fellow citizens into the anxious fold.

My first response to the article is this: I say NO to Scott Stossel and instead I say let’s think bigger and instead let’s invite the anxious citizens into the calm and no-more-anxiety fold!

Scott’s book is well-written book, offers an excellent understanding of what it feels like to experience anxiety and panic attacks, and has many compelling stories. But as a number of his Amazon reviewer’s say the big question is this: what is the answer or solution? Unfortunately it’s not provided in his book (or the New York Times Magazine article).

The New York Times Magazine article provides another anxiety resource that has helped “bring anxiety into the open, and allowed its clinical sufferers to band together in a virtual group-therapy setting”: The Sarah Fader on twitter, creator of the hashtag #ThisIsWhatAnxietyFeelsLike and a mental-health advocacy organization called Stigma Fighters.

Again, these are wonderful resources for support, awareness and advocacy but they don’t offer solutions if you suffer from anxiety. With nutritional solutions we can change this to #ThisIsWhatCalmFeelsLike.

#3 Too few people know about nutritional solutions

Too few people know about nutritional solutions and that has to change. Clinically we know it works and there is now SO much research supporting this approach.

Here are a few of many blog posts on my site that share powerful anxiety nutrition solutions:

I’m sharing this question I received on my GABA Calm blog to illustrate how different people respond to GABA and how some people may not even have the low GABA type of anxiety. Here is the question this mom posted:

I have used GABA (several brands, just open capsule and sprinkle small amount under tongue) for years now, with calming results within minutes. It was recommended to me by 2 family members, both bi-polar, who were tested by Dr. Amen. I have also used it with my children (now adults); my daughter says it doesn’t work for her. (She has anxiety issues and occasional panic attacks, and Rescue Remedy helps her.) It does work to calm my 3 sons, but one says it makes him sleepy, and lasts into the next day, so he won’t take it. Trudy, have you heard of this reaction? It seems extreme for such a small amount used. He is a college student and ‘medicates’ with caffeine, if that makes a difference.

She shared that she uses 500mg or 750mg capsules of GABA, and get several doses from a single cap (so maybe 100mg per dose).

This is what I shared with her: we are all biochemically different and one form of GABA (or GABA combined with other amino acids/nutrients such as GABA Calm) may work for one person and not another. Also one person may need more and another may do fine with much much less. Also anxiety has many underlying causes, with low GABA only being one of them.

If I was working with your daughter I’d have her trial higher amounts of GABA for the anxiety and panic attacks. I’d also look into low serotonin and a trial of tryptophan too especially if her anxiety is the worry, ruminating anxiety with insomnia and the blues, with increased afternoon and evening cravings for carbs and chocolates.

If I was working with your son, because it does work to calm him, I’d start by having him trial just 25mg of GABA and increase slowly from there, monitoring how he feels. His anxiety may also be related to his caffeine consumption – which can also affect sleep and the fatigue he feels in the morning could be related to that.

Note: She did ask this question on the GABA Calm blog and was planning to have them trial this form of GABA. I typically don’t have clients use GABA Calm at night (because of the tyrosine) but it’s certainly worth a trial especially with her son.

If you’re completely new to the amino acids for anxiety here is an overview with questionnaire, precautions and how to do a trial.